Papillitis in Neurosyphilis

Abstract

We present a case of a 47-year-old female patient, with papillitis in the right eye and anterior uveitis in both eyes, as a manifestation of untreated neurosyphilis.

Bilateral papillitis as the initial presentation of neurosyphilis in a patient previously treated for primary and secondary syphilis

“…The differential diagnosis for anterior uveitis and papillitis is broad and includes sarcoidosis, leukemia, infectious etiologies such as toxoplasmosis, syphilis and tuberculosis. 7 , 8 , 9 , 10 , 11 Our patient's presentation was non-specific, however, in conjunction with his recent positive VDRL, the diagnosis of ocular syphilis should be highly considered and evaluated. ***…”

Ocular Point-of-Care Ultrasound

“…However, POCUS did not show evidence of papilledema, nor was this appreciated on the patient's formal ophthalmologic evaluation. This discrepancy is well documented in literature and may be explained by the existence of papillitis or the inflammation of the anterior portion of the optic nerve 9,10 …”

“…This discrepancy is well documented in literature and may be explained by the existence of papillitis or the inflammation of the anterior portion of the optic nerve. 9,10 Our patient was ultimately diagnosed with uveitis. The use of high-frequency (50 MHz) biomicroscopy ultrasound has been well established in assessing for this pathology.…”

Syphilitic optic neuritis and uveitis – case report

“…The most common symptoms reported by patients include reduced visual acuity, ocular pain and headache, photophobia, red eyes, and increased lacrimation. In some cases, the disease may progress asymptomatically [3,[7][8][9][10]. Possible complications include the development of cataract, glaucoma, epiretinal membrane, optic nerve atrophy, or retinal detachment [8].…”